title: Circulating microparticles of glial origin and tissue factor bearing in high-grade glioma: a potential prothrombotic role.
abstract: Venous thromboembolism (VTE) may complicate the clinical course of glioblastoma multiforme (GBM). Circulating microparticles (MPs) have been associated with cancer-related VTE. Sixty-one consecutive patients with GBM undergoing gross-total (41) or subtotal (20) surgical resection followed by radio-chemotherapy were prospectively evaluated. MPs numbers according to cellular origin and the procoagulant activity of annexin V positive (AV+) MPs (MP-activity) were measured before surgery and then 1 week and 1, 4, and 7 months after surgery. Glial (GFAP+) and endothelial (CD62E+) derived MPs, AV+ and tissue factor-bearing (TF+) MPs were measured using flow cytometry. Baseline levels of GFAP+/TF-, TF+/GFAP-, and GFAP+/TF+ MPs were significantly higher in GBM patients than in healthy controls, and significantly increased at each time point after surgery; at 7 months, a further significant increase over the level found a week after surgery was only seen in the subtotally resected patients. The number AV+/CD62E- MPs increased in GBM patients and correlated with MP activity. TF+/GFAP- MPs numbers were significantly higher in 11 GBM patients who developed VTE than in those who did not (p 0.04). TF+/GFAP- MPs levels above the 90th percentile (calculated in GBM patients without VTE) were associated with a higher risk of VTE (RR 4.17, 95% CI 1.57-11.03). In conclusion, the numbers of glial-derived and/or TF-bearing MPs were high in GBM patients both before and even more after the neoplasm was treated, especially in patients with subtotal resection likely according to disease progression. A contribution of TF+/GFAP- MPs to the risk of VTE is suggested.
authors.affiliation: Department of Cardiologic, Thoracic and Vascular Sciences, via Giustiniani 2, Padua, Italy. mtsart@unipd.it
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Sartori
authors.forename: Alessandro
authors.initials: A
authors.lastname: Della Puppa
authors.forename: Andrea
authors.initials: A
authors.lastname: Ballin
authors.forename: Elena
authors.initials: E
authors.lastname: Campello
authors.forename: Claudia Maria
authors.initials: CM
authors.lastname: Radu
authors.forename: Graziella
authors.initials: G
authors.lastname: Saggiorato
authors.forename: Domenico
authors.initials: D
authors.lastname: d'Avella
authors.forename: Renato
authors.initials: R
authors.lastname: Scienza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cella
authors.forename: Paolo
authors.initials: P
authors.lastname: Simioni
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000097:blood* / Q000150:complications*; D016022:Case-Control Studies; D055252:Cell-Derived Microparticles / Q000378:metabolism / Q000473:pathology*; D019040:E-Selectin / Q000097:blood; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood; D005909:Glioblastoma / Q000097:blood* / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009457:Neuroglia / Q000473:pathology; D012307:Risk Factors; D013925:Thromboplastin / Q000378:metabolism*; D054556:Venous Thromboembolism / Q000097:blood* / Q000209:etiology*
chemical_list: D019040:E-Selectin; D005904:Glial Fibrillary Acidic Protein; D013925:Thromboplastin